1. A family is gathered around in the ICU waiting room to monitor the status of a 22-year-old male, David, who sustained traumatic injuries in a motorcycle accident. He is in critical unstable condition with many wounds and severe abrasions. David’s mom keeps crying and saying, “What did I do to deserve this, God?” The family is Roman Catholic.
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- a. What information should you ask the family regarding their culture, beliefs, and coping mechanisms?
- b. The family wants to be at the bedside with David and requests to be present if he has a code blue or becomes asystolic.
- c. What is your best response to their request?
2. A 45-year-old divorced Filipino man with end-stage Alzheimer’s disease was found dead from hanging. While preparing the body for the morgue, the mother tells the nurse that he has disgraced the family and he will go to hell.
- a. What religious or spiritual beliefs influenced the mother’s reaction?
- b. How should the nurse respond to the mother?
Submission Instructions:
- Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
Chapter
1
1:
Culture, Family, and Community
Copyright © 2016 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright © 2020 Wolters Kluwer • All Rights Reserved
1
Community-Based Settings #1
An understanding of culture and cultural concepts contributes to the nurse’s knowledge and facilitates culturally competent nursing care in community-based settings.
Nurses are moving from acute care to community-based settings, with the trend expected to increase.
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2
Community-Based Settings #2
Concepts such as health equality, diversity, partnership, empowerment, and facilitation now form the basis for community-based nursing practice with individuals, families, and aggregates in the community.
An aggregate is a collection of people who can be thought of as a whole simply because they happen to be in the same place at the same time.
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3
Community-Based Settings #3
Community-based collaborative action research (CBCAR) is an approach for nurses to partner with communities to address health issues.
Care that is not congruent with the client’s value system is likely to increase the cost of care because it compromises quality and inhibits access to services.
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4
Overview of Culturally Competent Nursing Care in Community Settings
The use of cultural knowledge in community-based nursing practice begins with a careful assessment of clients and families in their own environments.
Cultural data are discussed with the client and family to develop mutually shared goals.
Nurses must take into account the diverse cultural factors that will motivate clients to make successful changes in lifestyle and behavioral modifications.
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5
A Transcultural Framework
Cultural/social/ecological approach:
Nursing focus is on the community as client.
A cultural/social/ecological framework facilitates a view of the community as a complex collective yet allows for diversity within the whole.
Assists the nurse to identify values and cultural norms of a community.
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6
Question #1
Is the following statement true or false?
The goal of practicing in a culturally sensitive manner is to provide care that the client, family, and health care providers are in agreement with.
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7
Answer to Question #1
True
Rationale: The use of cultural knowledge in community-based nursing practice begins with a careful assessment of clients and families in their own environments. Cultural data that have implications for nursing care are selected from clients, families, and the environment during the assessment phase and are discussed with the client and family to develop mutually shared goals.
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8
Cultural Issues in Community Nursing Practice #1
Cultural influences on individuals/families:
Family structure, roles, communication, decision-making
Health beliefs/practices, alternative therapies
Patterns of daily living
Social networks
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9
Cultural Issues in Community Nursing Practice #2
Cultural influences on individuals/families (cont.):
Identification with a cultural group, language
Nutritional practices
Religious preferences
Culturally appropriate behavior styles
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Cultural Issues in Community Nursing Practice #3
Cultural factors within communities:
Influence of demographics on health care; the United States is more diverse; morbidity/mortality rates
Subcultures in the United States and diversity within them
Refugee and immigrant populations, asylees
Dinka community
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11
Cultural Issues in Community Nursing Practice #4
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12
Cultural Issues in Community Nursing Practice #5
Cultural factors within communities (cont.):
Maintenance of traditional cultural values and practices, assimilation, acculturation, integration
Access to health and nursing care for diverse cultural groups :
Economic status
Discriminatory factors
Geographic location
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Question #2
Is the following statement true or false?
Assimilation and acculturation can be defined as the process by which individuals shed their traditional culture and lifestyle and embrace and adapt to their new culture—something all successful immigrants and refugees experience.
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14
Answer to Question #2
False
Rationale: The terms assimilation and acculturation refer to ways in which immigrants and refugees adapt and change over time. These terms may imply giving up one’s traditional culture for the dominant culture. Integration, incorporating some aspects of the new culture while maintaining cultural traditions and values, may better describe a successful immigrant or refugee experience.
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15
Assessment of Culturally Diverse Communities #1
The community nursing assessment often focuses on a broad goal, such as improvement in the health status of a group of people.
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16
Assessment of Culturally Diverse Communities #2
Basic Principles of Cultural Assessments:
All cultures must be viewed in the context in which they have developed.
The meaning and purpose of the behavior must be interpreted within the context of the specific culture.
There is such a phenomenon as intracultural variation.
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17
Assessment of Culturally Diverse Communities #3
Cultural competence in health maintenance and health promotion:
Cultural competence in community settings begins with anticipatory planning.
Cultural sensitivity, the ability to be aware of the needs and emotions of others, is essential to meeting health needs that exist within diverse cultural groups.
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18
Assessment of Culturally Diverse Communities #4
Cultural competence in health maintenance and health promotion (cont.):
Requires knowledge about:
Family systems
Coping behaviors
Lifestyle practices
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Assessment of Culturally Diverse Communities #5
Cultural competence in primary, secondary, and tertiary preventive programs:
The major aim of community-based preventive programs is to reduce the risk for the population at large, rather than to prevent illnesses in specific individuals.
In their daily practice, community nurses are often involved in activities related to all three levels of prevention.
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20
Assessment of Culturally Diverse Communities #6
Cultural Competence in primary, secondary, and tertiary preventive programs (cont.):
Primary—prevent the occurrence of an illness, disease, or health risk
Secondary—early diagnosis and appropriate treatment of a condition or disease
Tertiary—rehabilitation and the prevention of recurrences or complications
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21
Question #3
The community health nurse should target certain high-risk behaviors for change during pregnancy, such as smoking, using drugs, consuming alcohol, and maintaining poor nutritional habits. Which of the following levels of prevention does this demonstrate?
Primary
Secondary
Tertiary
Assessment
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22
Answer to Question #3
A. Primary
Rationale: A program of primary prevention would focus on preventing infant morbidity and mortality and other health problems in mothers and their infants.
Early prenatal care may enhance pregnancy outcome and maternal health by assessing risk, providing health advice, and managing chronic and pregnancy-related health conditions.
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23
Chapter
1
2:
Religion, Culture, and Nursing
Copyright © 2016 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright © 2020 Wolters Kluwer • All Rights Reserved
1
Religion, Culture, and Nursing
As an integral component of culture, religious, and spiritual beliefs, influence a client’s explanation of the:
Cause(s) of illness
Perception of its severity
Decisions about healing intervention(s)
Choice of healer(s)
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2
Dimensions of Religion #1
Five major dimensions of religion:
Experiential—emotion and/or feeling about purpose in life and connection with a higher power
Ritualistic—religious practices
Ideologic—shared beliefs of members
Intellectual—cognitive understanding
Consequential—adherence to the prescribed standards of conduct
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3
Dimensions of Religion #2
Religious Dimensions in Relation to Health and Illness
Determine the dimensions important to the client for mutual goal setting and priorities.
Determine what a given member of a specific religious affiliation believes to be important.
Obtain accurate information.
Understand religious virtues of clients.
Assist clients to cope with differences between their own behaviors and the norms of their religion.
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Religion and Spiritual Nursing Care
Nurses endeavor to provide holistic health care, in which the needs of the total person are recognized.
Religion is an organized system of beliefs about the cause, nature, and purpose of the universe, often including the belief in or worship of a Supreme Being and a unified truth.
Spirituality is a person’s personal effort to find meaning and purpose in his or her life. It is more focused on individual growth, more subjective, more emotionally based, and rising from personal experience.
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5
Question #1
Is the following statement true or false?
Religion addresses questions related to what is true and right.
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Answer to Question #1
True
Rationale: Religion addresses questions related to what is true and right and helps individuals determine where they belong in the scheme of their life’s journey.
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Spiritual Nursing Care #1
Spiritual intervention is as appropriate as any other form of nursing intervention and recognizes that the balance of physical, psychosocial, and spiritual aspects of life is essential to overall good health.
Spiritual distress is disruption in the life principle that pervades a person’s entire being and that integrates and transcends the person’s biologic and psychosocial nature.
Cultural assessment includes assessment of religious and spiritual issues.
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8
Spiritual Nursing Care #2
Spiritual Nursing Care for the Dying or Bereaved Client and Family
Death of a child
Death practices
Preparation of the body
Funeral practices
Taboos
Unexpected and violent death
Bereavement, grief, mourning
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9
Question #2
Is the following statement true or false?
While attention to a client’s spiritual needs is always important, most clients view religion as a private matter, especially at a time of crisis.
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10
Answer to Question #2
False
Rationale: The goal of spiritual nursing care is to assist clients in integrating their own religious and spiritual beliefs into the ultimate reality that gives meaning to their lives in relation to the health care crisis that has precipitated the need for nursing care.
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11
Religious Trends in the United States and Canada #1
The United States and Canada are cosmopolitan nations to which all of the major and many of the minor faiths of Europe and other parts of the globe have been transplanted.
Religious identification among people from different racial and ethnic groups is important because religion and culture are interwoven.
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12
Religious Trends in the United States and Canada #2
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13
Contributions of Religious Groups to the Health Care Delivery System
Many religious denominations own and operate health care institutions and make significant fiscal contributions that help control health care costs.
Roman Catholic Church–affiliated hospitals, health-related centers, charities
Jewish hospitals, day care centers, extended care facilities, and organizations
Lutheran, Mennonite, Methodist, Muslim, and Seventh-Day Adventist groups also own and operate hospitals and health care organizations
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14
Question #3
The second most popular religious affiliation identified by individuals in the United States is:
Christianity
Judaism
Islam
Atheism, Agnosticism, no affiliation
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15
Answer to Question #3
D. Atheism, Agnosticism, no affiliation
Rationale: In the United States, Christianity is the most popular religious affiliation identified (at 78.5%). Second to that, at 17.3%, is the category Atheism, Agnosticism, no affiliation.
Worldwide, Islam is second to Christianity (at 19.6% and 33%, respectively).
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16
Health-Related Beliefs and Practices of Selected Religions #1
Health-related beliefs and practices of select religions are important to understand, especially considering the diverse religious groups in the United States and Canada.
A brief overview of the following religions can be found in the text:
Amish
Baha’i International Community
Buddhist Churches of America
Catholicism According to the Roman Rite
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Health-Related Beliefs and Practices of Selected Religions #2
A brief overview of the following religions can be found in the text (cont.):
Christian Science
The Church of Jesus Christ of Latter-day Saints
Hinduism
Islam
Jehovah’s Witnesses
Judaism
Mennonite Church
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Health-Related Beliefs and Practices of Selected Religions #3
A brief overview of the following religions can be found in the text (cont.):
Mennonite Church
Native North American Churches
Protestantism
Seventh-Day Adventists
Unitarian Universalist Church
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